SUSAN J SAM - NPI 1225565377 - Nurse Practitioner in Grosse Pointe, MI

Q: What is the provider's specialty?

The provider's specialty is Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.

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About Susan J Sam NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUSAN J SAM (NPI 1225565377) is an individual family provider in Grosse Pointe, Michigan, licensed in Michigan (4704257975) and active in the NPI registry since May 2017. She maintains a secondary practice location in Troy.

NPPES Registry Identity

NPI1225565377

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameSUSAN J SAM

Location Address468 CADIEUX RDGrosse Pointe, MI 48230-1507

Mailing Address7146 N Central ParkShelby Twp, MI 48317-2388 · (586) 722-3339

Phone(313) 473-1605

Sole ProprietorNo

Enumeration DateMay 20, 2017

Last NPPES UpdateJanuary 6, 20212 updates tracked since enumeration

NPPES CertifiedJanuary 6, 2021

✔ NPI 1225565377 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MI · 4704257975

Also ListedRegistered Nurse · Medical-SurgicalTaxonomy 163WM0705X · License 4704257975 (MI)

468 CADIEUX RD, Grosse Pointe, MI 48230

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Secondary Practice Location 1

Location 144201 Dequindre RdTroy, MI 48085-1117 · Phone (248) 964-5000

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BEAUMONT PHARMACY AND HEALTH SERVICES INC

Pharmacy (Community/Retail Pharmacy)